Action Learning in English and Anatomy - CEIcei.ust.hk/files/public/zfhku18371-385.pdf · Action Learning in English and Anatomy 373 reached this diagnosis. Patient cases always related

Action Learning in English and Anatomy 371

Action Learning in English and Anatomy

Marie Lenstrup, Peter Lucas, Jon Prinz, George Tipoe, Denis Williamson andHenry Yip*The University of Hong Kong

A b s t r a c t

In 1994, the Medical Faculty started to revise its curriculum, adapting it to recent trends in medicaleducation by allowing for increased student participation. Part of these changes involved recognition ofthe second language factor in Hong Kong education. An English Enchancement programme for medicalstudents was also started in 1994, and worked in concert with the Gross Anatomy course which isrenowned for its (usually unquantified but heavy) terminological load. The concurrent upsurge in interestin Action Research within Hong Kong offered the opportunity to initiate a quantified project that could helpmonitor the developments in both Anatomy and English Enhancement.

On the Anatomy side, tutorials were observed and audiotaped. Subsequent semi-automated analysis ofthese tapes quantified student versus teacher participation. Individual student participation was alsoquantified using a real-time computer analysis (TUTOR — specifically–written for the Action Researchproject) operated by the observer. Students were also given simple verbal and non-verbal quizzes at theend of the tutorials. In addition, student case presentations were videotaped and practical sessions wereobserved. The final examination results in Anatomy of previous students were also correlated with their A-level grades in Science and the Use of English. Our general conclusion from these investigations is thatlanguage is a vital factor in the acquisition of anatomical knowledge at The University of Hong Kong. Thismay explain why students have great difficulty, initially, in reading assigned texts. The (expected) rate ofassimilation of terms in the first few weeks of the anatomy course is staggering (e.g., 600 terms in the firstfew weeks alone!). This knowledge has been incorporated into subsequent course revisions, allowing formuch more realistic expectations of student progress in a second language setting.

Introduction

Background

In 1993, the Faculty of Medicine at the University of Hong Kong initiated a reform of itscurriculum. The Anatomy Department made a major change in its Gross Anatomy course (which isthat part of anatomy visible at the naked eye level), starting in the academic year of 1994-1995. Thisconsisted of a 15 per cent reduction in formal teaching, a change of instruction manual for thepracticals and more interaction during tutorials. The faculty as a whole did not go through withthe reform at that time.

Coincident with this quest for reform, the University introduced English Enhancementprogrammes in all faculties. Denis Williamson, who was placed in charge of this programme forthe Medical Faculty, started to contact faculty members in an attempt to integrate the Englishcourse into the medical programme in order to maximise its relevance. In May 1994, on anemphasis in English on gross anatomy was agreed upon. In order to assess the success of the twochanges in the curricula, we sought and obtained an Action Learning Project (ALP). This motivatedthe designers of both courses to more formally investigate current practices, to monitor the effects

372 English Language

of the changes that were planned and to document the whole project. The major objectives were (i)to identify major hurdles encountered by students in learning gross anatomy and (ii) to encouragemore student participation. Unfortunately, all of this transpired too close to the changes incurriculum to assess any clear baseline in the course that had existed for more than ten yearspreviously.

English

Increasing Student Participation

Already somewhat dissatisfied with the way its first year students were learning Anatomy, theDepartment held an hypothesis that students' results might improve if students were to play agreater role in the learning process. If the teaching were to be less didactic, and more interactive,students might rely less on ‘receiving what they need to know’ from the teachers and come to‘investigate more of what they decide they need to know’. This goal of increased studentparticipation also seemed a suitable ‘hook’ onto which an English Enhancement curriculum couldbe hung. Enhancement courses are designed to be interactive, with student activities guiding thelanguage that is produced, and student participation being a necessary element of Englishclassroom lessons. The English curriculum, therefore, would take several of the activities that wereto be part of the ‘new’ Anatomy curriculum and practise them in the English Enhancementclassroom, with the same students and with content drawn directly from the Anatomy classes.

Baselines

First of all, however, we had to try and get some idea of how much participation there already wasin our classrooms and indeed how much or how little we encouraged, or actually allowed,students to participate in our lessons.

Therefore, classroom observations were carried out in both courses, using one or more of thefollowing: a human observer (our research assistant), video recordings, audio recordings andcomputer recorded data (more on the computer data will be discussed below).

Even at this stage, teachers found areas of their behaviour where there was scope for immediateimprovement: From over-explanation by the English teacher to mini-lectures by the Anatomyteachers during tutorials.

• Student activities in the Anatomy curriculum which were chosen to be practised in the Englishclassroom were:

• Oral presentations of patient case-histories

• Reading of an instruction manual in Dissection, before dissection sessions.

Other activities in the English curriculum included the building of Medical terminology fromprefixes, roots and suffixes, and the almost constant, small group discussion related to preparingfor or performing the above activities.

Oral Presentations

First Cycle Action

Students were given a problem in the form of a set of symptoms experienced by a patient. Theirtask was to work out a diagnosis of this patient and to present, in a lucid way, how they had


reached this diagnosis. Patient cases always related to the topics/parts of the body being studied inAnatomy, in which the final presentations were made during an Anatomy lesson and in front ofthe students’ 170 colleagues. Students worked their own way through the medical diagnoses ofthese problems, and brought their data to the English class. Presentation skills sessions trained andpolished the way the students presented.

Observations

Although the initial presentations were well attended and well received, by the end of theacademic year, when class tests were looming large on the horizon, attendance of the audiencedropped considerably. After two years of holding presentations this way, opinions expressed bythe students who attended the presentations were that they learned so little from them that thetime would be better spent reading their textbooks and preparing for the tests. In short, thepresentations had turned into ‘exhibition pieces’ for the presenters, who undoubtedly learnedsomething new from their problem solving task, but a ‘non-event’ for the audience.

Second Cycle Reflection and Action

Although it was still felt that learning and practising presentation techniques were activities thatwould be of benefit to students, it was clear that the present arrangements could not continue. Thenext step, therefore, was to keep the presentations, but to change the context. Presentations becamepart of Anatomy tutorials. Tutorial groups have 14 to 15 students only. The presentations wouldtherefore be much more informal. It was also suggested that the objective of each presentationwould be to teach the other students in the group, who had not gone through the same case.Groups of 14 to 15 students would divide into three smaller groups, each with its own case to workon.

Anatomy tutorial groups also formed the basis of the groupings for English. Students were stillgiven case-histories in the English lesson, which were still related to the topics/parts of the bodythat students were studying simultaneously in Anatomy. However, this time, and in line with agrowing awareness of the techniques of ‘Problem Based Learning’ (PBL), the cases were dividedinto stages, allowing students to discuss one stage at a time and to narrow their diagnoses eachtime they received more information.

This process of discussion markedly changed the activities in the English classroom. Instead ofstudents working on the diagnoses between classes and practising presentations in class, class timewas used for the actual discussions, wherein students worked out diagnoses using their own,limited medical knowledge and whatever they could gain from their textbooks. Practice ofinformal presentations (e.g., using hand held flip charts instead of OHTs in order to present in thesmaller tutorial rooms) was fitted in after these discussions.

Observations

Some of the discussions in the English class were a joy to behold. Data from student feedback arestill being collated, but initial impressions from watching student behaviour is that students carryout whole discussions in English, and whilst they take a long time to reach decisions, andsometimes make ‘medical mistakes’, they are really immersed in the activity.

The whole Medical Faculty is planning to make a curriculum switch in September 1997 towardsthe use of PBL across the board. This initial attempt by the English course has shown that forEnglish, it is indeed a way to involve students in the learning process.


Reading the Dissection Manual (Grant's Dissector 11th Edn.)

This dissection manual was first introduced in September 1994, the year of the curriculum revision,accompanied by some concern from the Anatomy staff that it may be too simple for the students,especially when compared to the dissection manual used in previous years. Actually, it becameapparent after a couple of weeks that the dissection manual was proving to be very difficult formany students to understand.

The English course included sessions of reading dissections from the manual (incorporating theactivities of reading, discussion and presentation) and synchronising the readings with the actualdissections that students were to perform.

Over the three years that the English course has now been running (bearing in mind that Englishclasses for first year students run for only the first eight weeks of each year) data was collectedfrom students to show:

(a) that students spend a lot of time reading Grant during the early weeks of the year;

(b) that actual dissections done by students immediately after English lessons where Grant wasread and discussed in class were easier for students than when this was not the case; and

(c) the actual words and phrases in the manual caused problems to five students who agreed tohelp out with our data gathering.

There was also anecdotal evidence gathered from Anatomy teachers and other staff involved in thedissection sessions which supported the idea that the dissection performed was of a higher qualitythan in the years before any of these revisions took place.

Current Reflection

In order to ease the pressure on student reading for dissection, the current thinking is considering achange to the present set up by introducing either:

(a) a new set of dissection instructions,written locally, to replace Grant; or

(b) a set of ‘pre-teaching’ sessions in the English class, which would heighten student awareness ofthe ‘problem’ words and phrases highlighted by students in (c) above.

There is also scope here for an analysis of the discourse used in Grant’s Dissector. Like some othertypes of instruction manuals (one thinks of manuals that accompany some computer software)there is a noticeable gap between the perceptions of experts who read the manuals and find themsimple to understand, and the perceptions of novices, who read the manuals and often find themlargely incomprehensible. Why is this so? What features does the language of Grant’s Dissectorhave that puts it in this category?

Initial investigation shows that there is a lot of ‘exophoric reference’ in the manual; i.e., text whichrefers to a body of knowledge that a reader is assumed to have. Items are named, but notexplained. Anatomy teachers, of course, already have this body of knowledge (which isundoubtedly why they considered the book to be easy), but new medical students have not yet hadtime to build up such a body, and this is perhaps a main reason why they find reading the manualso difficult in the early weeks of their first year.

The discourse analysis will form the basis of continuing research on the English side of the project.


Anatomy

Course Innovations in the Gross Anatomy Course from 1994

A set of objectives were introduced as a structure for the entire course. These were contained in acourse booklet handed to each student at the start of the course.

A change was made in the dissection manual as students now used Grant’s Dissector (11th edn,Sauerland, 1994), which was much shorter than the previous dissector (Zuckerman, Darlingtonand Lisowski, 1981). It was hoped that the new dissector would be simpler for the students tofollow.

Incorporation of students into one of 12 groups preserved throughout the 18 months of the course,for the purposes of small-group tutorials and case presentations. Tutorials were increased innumber. Previously, these 90-minute sessions, involving 14-16 students and one teacher, had beenloosely arranged. The structure was now understood by all students to be based around objectivesgiven in the course book. Given that all students knew the objectives beforehand, it was hoped thatthis would increase student participation.

The introduction of student case presentations

Between four to five representatives of each group presented the anatomical aspects of a clinicalcase in a 10-15 minute period in a lecture theatre in front of the other students and a team of fourlecturers. In addition, half of the students underwent team-building sessions organised by staff ofthe Personal Development and Counselling Centre at the University just prior to the start of theyear.

Methodology

Analysis of Linguistic Load

The students were given assigned reading for every week of the course in both the dissectionmanual and textbook. One staff member went through the set readings given for the first semester,noting the point within these two books where each specialised term (anatomical or clinical) wasintroduced for the first time. Afterwards, the number of new terms introduced in each week wastallied. This provided a quantified assessment of the assumed terminological ‘learning curve’ inEnglish that students have to scale. In addition, Nomina Anatomica, the international standard foranatomical terms, and medical dictionaries were scanned to find out the size of the anatomical andmedical lexicon.

Tutorials

Tutorials formed a focal point of the new course. These had existed in the Gross Anatomy coursebefore, but in smaller numbers and had generally taken a didactic form. The emphasis now was onincreased student participation.

Tutorials were observed. The observer acted, in one capacity, as a ‘critical friend’ (though thisepithet is recognised as a distortion of action learning procedures). The observer issued reports totutors afterwards.

All 90-minute tutorials were audiotaped. Utilising the stereophonic capacity of recorders, thestudents' participation was recorded onto one channel through microphones wired in series laid on


the table, while the tutor was recorded on the other. These tapes were later digitised, allowingautomated analysis of the proportion of time that tutor and tutees spoke.

In some tutorials, the observer also operated a specially-written computer program calledMUTTER. This involved assigning keys on a notebook computer keyboard to participants in thetutorial. When anyone started to speak, the key assigned to them would be pressed. The programlogged the time spent talking. When they stopped, a second key press stopped the computer log.

Afterwards, analysis of a combination of (ii) and (iii) provided a profile of the tutorial, charting theinteractions of the participants. Since there was only one research assistant, but three anatomy staffon the project simultaneously running tutorials, most tutorials only had audiotape records.

At the end of the tutorials, quizzes were given to test students’ memory of the topics that had beencovered during these 90-minute sessions. Each quiz had a verbal (MCQ) and non-verbal element.The latter involved the labelling of a diagram, which used as little linguistic content as possible. Asshown in Figure 1, students could select from a list of terms that included the correctidentifications of structures in the diagram by placing a letter against a particular structuralfeature. In tutorials with an observer and MUTTER, the computer key identifying that participantwas entered on the quiz sheet. This allowed correlation of participation in the tutorial and quizscores.

Lectures

Lectures were videotaped using a small video camera connected to a notebook computer, placed ina convenient location (e.g., on a lectern) and facing the audience. Using a specially-writtenprogram, the computer captured a frame from the camera and stored it. Subsequent to the lecture,adjacent frames were played back into computer memory and compared. A digital subtractionallowed all areas of the image that showed colour shifts to be summed. These colour shiftsrepresented movements in the audience. A record of these movements could then be picked upover the course of the lecture.

Case Presentations

In the first two years of the course, representatives from student groups presented cases in alecture theatre. These were videotaped in a conventional manner. Each presentation was scored byjudges from the academic staff.

Practicals

Dissection sessions are a traditional method of teaching three-dimensional morphology. Success inthese problem-solving practicals depends heavily on group cooperation. These sessions were bothvideotaped in the same manner as lectures and also observed with an eye to the roles adopted bystudents around the dissection tables.

Analysis of Examination Scripts

Randomly-selected scripts from a term test were assessed for their language by the researchassistant. Scripts were assigned to one of three grades on the basis of their use of English. Emphasiswas placed on clarity and lack of ambiguity rather than on grammatical and spelling mistakes thatdid not distort meaning. These grades were then correlated with the mark that had been given bythe examiner.

Five-minute tests on topics being currently taught in Gross Anatomy were set at the end of theEnglish lessons. These were marked by anatomy staff. Grades awarded by the examiners were also


compared with the length of answers given by the students, as measured simply with a ruler. Finalexamination papers in Anatomy were not available for study. However, actual grades wereexamined in relation to the English and Science A-level grades obtained prior to entry touniversity.

Questionnaires

Students were issued with questionnaires that attempted to identify the characteristics they wishedto see in an ideal teacher. Blind to these results, staff on the project were issued with a series ofaudiotapes of tutorials, representing one to two tutorials chosen at random from those facilitatedby each staff member. These were coupled with questionnaires, paralleling much of the studentquestionnaires, which were completed before and after listening to each tape.

Results and Discussion

Samples of results are given here to indicate the value or lack of it of some of the innovativemeasures of participation that we attempted. These are selected because they proved important inreflecting on what to do next.

Figure 1 plots the astonishing rate at which students are apparently expected to pick up anatomicalterms. The textbook includes many more terms than the dissector, but the latter is intended only toinclude as much as is necessary in order to proceed with a practical task whereas the former mustdescribe structures fully. Nevertheless, it is doubtful whether 600 or more terms really need to bethrown to a student within the first week of university.

Figure 1: The anticipated rate at which students learn terms describing the human body at the ‘naked eye’level.

The dissector introduces only those terms required for identification whereas the textbook includesfull descriptions in relation to common clinical problems. Thus, some clinical terms are alsointroduced. The stars indicate the commencement of new regions of the body.


An investigation of core medical dictionaries, i.e., those that do not delve into sub-specialties,reveals a lexicon of about 25,000 terms. In contrast, the total terminiology in Nomina Anatomica isjust less than 6,000 terms. Thus, although the terminological load in anaotmy is very high, it is notexceptional within the framework of a medical career.

Tutorials

Tutors differed substantially in the format that they adopted for these sessions. Some tutors wouldlead the session with a rapid ‘question & answer’ format, while others would assign topics togroups of students who then made mini-presentations after some minutes of reflection and groupdiscussion. These differences emerged very clearly in the digital analysis of the audiotapes. InFigure 2, it can be seen that both tutor and students have very short utterance time, reflecting a‘question & answer’ format while in Figure 3, the staff member is initially either giving a mini-lecture or issuing instructions. Following this, students are then giving mini-presentations. Thesedifferences are easily confirmed by listening to short excerpts from the tapes. In either format, thestaff member is clearly not dominating tutorial time.

Figure 2: Digital analysis of audiotaped data from a tutorial run on a ‘question & answer’ basis.

The time axis is in seconds. The vertical axis reflects sound levels on the two channels recorded.Levels above zero reflect teacher dominance, while the opposite shows student dominance.


Figure 3: Analysis of a tutorial utilising a ‘mini-presentation’ model format. Axes as in Fig. 2.

Students still dominate tutorial time as a whole but their individual contributions last longer. It ispossible to analyse the timespan of each utterance using this program. However, MUTTER wasused for most analysis of this type.

Analysis of the tapes was, however, inadequate to document student interaction and the evennessof coverage of topics in tutorials. Instead, the observer’s reports proved invaluable in this regard,initiating a change of tutorial format on several occasions. As an example of a simple observationthat escaped the tutor’s attention, students assigned a topic for mini-presentation actually tendedto sub-divide the topic between themselves very quickly and then proceed to revise it solitarily inthe minutes available to them. Subsequently, the tutor involved attempted to interact with studentgroups periodically during their preparation in an attempt to engender more group learning.

MUTTER was important in defining the levels of participation of individual students. Generally,students had very short mean and total utterance times of students during these sessions,regardless of the format adopted by the tutor. However, actual timings depended on whetherpauses were recorded or not. To test whether this was a cause for concern or not, two observersrecorded one tutorial using two computers. High correlations were found between their results.

Sample data for four students from a 90-minute tutorial are shown in Table 1. One male studentdominated, although no overall differences between the contributions of males and females werefound. Curiously, this male student faired worse in the tutorial quiz than one of the females whospoke very little (83 seconds during the whole tutorial). In general, there was no correlationbetween levels of participation and retention of information as judged by the tutorial quizzes.


Table 1: Selected results from one tutorial using MUTTER.

SEX Total utterance time

(sec)

mean utterance

time (sec)

verbal test score

(out of 10)

non-verbal test

score(out of 12)

male 68 5 10 9

male 370 16 8 10

female 47 9 4 12

female 83 12 10 12

MUTTER documents participation in the tutorial, as expressed in total and mean utterance times.This appears uncorrelated with tutorial quiz results.

Lectures

The pattern of student activity within a typical lecture is shown in Figure 4. Students tended totake some time to settle down. However, following this, activity levels were low with periodicbursts of note-taking. Activity levels rose towards the end of a lecture as students apparently‘packed up’ early. At present, all that can be gathered from such activity records is that zeroactivity is indistinguishable from sleep. High levels likely reflect restlessness and fidgeting.Periodic bursts represent note-taking.

Figure 4: Results of a video recording of a whole lecture (the time axis records the number of frames, eachbeing 20 seconds apart).

Figure 4 shows that students took time to settle down, then showed brief periods of note-taking.Activity fell to very low levels during two periods.


Test Marks

Despite final anatomy scripts being unavailable, an indication of the importance of language skillscould be obtained by correlating students’ final grades in Anatomy with their A-level grades.Results of the grades of 292 students who entered the faculty in 1990-1993 are shown in Figures 5-7.It should be emphasised that there is a ‘close’ system of marking within the Department ofAnatomy: small differences in marks reflect substantial differences in performance.

Surprisingly, grades in A-level Biology have little clear relationship with the final Anatomy grade.(Figure 5). It does not even seem to matter much if Biology was taken or not, while it does matter ifstudents only barely managed to pass the subject with a grade ‘E’. The entrance level in Chemistry,the only required subject in which a ‘D’ or above is needed, is rather more significant and exhibitsa clear relationship with final examination marks (Figure 6). It is striking, however, that therelationship between the final examination score and the grade in Use of English (Figure 7) is moreimportant than that in Chemistry.

Figures 5-7: show the relationship between A level grades in Biology, Chemistry and Use of English on thehorizontal axis versus the final Anatomy examination score on the vertical axis (means are the small squares,the lines indicate two standard errors from the means). N.T.=Not Taken.


The research assistant also analysed half the answers (N=82) of one 10-minute term test question,assessing the quality and quantity of the written English. Scripts were assigned to one of threecategories of language quality (good, intermediate or poor English) on the basis of communicativeefficiency, rather than formal correctness. This means that errors that distorted or obscured


meaning (lexical mistakes, unfinished sentences, missing sentence elements and wrong wordorder) weighed more heavily than simple grammatical mistakes (e.g., lack of subject/verb andadjective/verb congruency, incorrect punctuation or missing articles) or spelling mistakes that,although disturb the smooth flow of text, do not distort meaning. Language does not lend itselfwell to quantification, but since student scripts were assessed by an experienced EFL/ESL teacher,results are deemed reliable. Quantity was assessed merely by measuring the length of the answerswith a ruler, all on lined paper and none with diagrams.

Both the style of English and length of answer, particularly the latter, are significantly correlatedwith examination marks (r=0.38, p<0.001 and r=0.56, p<0.001 respectively). Since it might(incorrectly) be assumed that the examiner based assessment on the length of answer, a multiplecorrelation employing both variables was performed. This shows that the correlation with lengthhardly rises at all (r = 0.60 for both measures combined). The most tempting conclusion is that astudent who is better at English is quite simply able to write more within the time limit. However,it is also possible that other factors contribute to the finding: either that students with poor Englishhave fewer resources for learning the subject matter of the course, or that poor English is onecharacteristic of a student with low potential for academic achievement in general (on this lastpoint, however, see below). Assessing the quantity of the answer with a ruler obviously does nottake into account variation in the size of handwriting, word or line spacing (some answers weredouble-spaced), but this method was quick and appeared to produce a significant result.

Five-Minute Paper Performance

Members of the English Centre gave out questions for very short (5 minute) tests at the end ofseveral of their English enhancement sessions. One of their aims was to check the results from classtests with three separate examiners. Examiners were instructed to mark solely on content. Markson these tests strongly support a relationship between length of answer and the mark given (Table2). In one of the tests (marked by examiner A), 11 students completely misunderstood the questionand wrote long answers off the point (for which they received no marks). Removing these scriptsfrom the data set greatly improves the positive correlation between answer length and mark (Table2).

Table 2: Correlation between length of answer to three different 5 minute papers with examiners' score.

Examiner N Correlation coefficient

A 74 0.38

63* 0.63

B 84 0.57

C 71 0.47

N is the number of scripts; * ignores 11 scripts on incorrect topic; p<0.001 in all cases.

Correlations between average tutorial quiz, case presentation and term test scores per group ofstudents were investigated (e.g., Table 3), but showed no obvious relationship. There was also noobvious relationship with team-building.


Table 3: The performance of four groups over a semester in terms of tutorial quizzes, case presentations andend-of-term (end-of-semester) marks.

GROUP mean verbal

test score

(out of 10)

mean non-

verbal test score

(out of 12)

Mean case score

(out of 5)

mean written

term test

mark (%)

mean practical

term test mark

(%)

B 6.9 6.9 3.3 51.3 59.8

C 5.8 7.6 4.2 55.2 59.1

K 7.5 7.8 3.8 55.7 55.8

L 7.1 6.8 3.7 50.5 63.6

Groups shown in bold had been subjected to ‘team building’ sessions in an attempt to increasegroup cooperation.

Practicals

A critical feature for the success of a gross anatomy course is the use that students make ofpracticals. Critical decisions need to be made between problem-solving, relatively-unguided,dissection sessions and spoon-feeding demonstrations. Videoing of dissection sessions revealedlittle about general activity levels. However, observations by the research assistant showed ahighly variable pattern and a misuse of these sessions by many students. In Table 4, there is anattempt to categorise the roles that students play in terms of a hospital analogy. The surgeon is thedissector, the intern is his helper, the nurse is the intern's helper, the administrative staff are heads-in-books (usually but always the dissector) and the relatives are inactive, often loitering. In the sixsub-groups in Table 4, which observed over four dissection sessions, the total number of rolesexceeds the group size showing that students do change roles. However, two of the sub-groupsclearly had a large number of inactive members.

Table 4: The roles played by students during dissection sessions, averaged over observations of four 3-hrsessions.

GROUP SIZE Surgeon Intern Nurse Administrative staff Relatives

6 3.0 0.3 2.3 3.7 1.0

7 2.7 0.3 0.0 0.0 4.0

4 2.0 1.0 0.0 0.3 0.7

4 1.3 1.0 0.0 1.0 1.3

6 2.3 0.0 0.7 2.0 1.0

7 2.3 2.3 0.3 1.3 3.0

Group size here refers to the group around a dissection table (a sub-group of those referred to inthe rest of this paper.)


Major Findings and Current Reflection

The project has documented an important link between ability in English and success in GrossAnatomy. The reason for this is fairly clear — anatomy is terminologically intensive. Anatomy isnot exceptional, merely being a microcosm of the medical world as a whole, which contains anenormous specialised vocabulary that grows steadily.

We could not establish any clear correlation between levels of participation by students in classesand their subsequent ability to retain information, either in the short or long term. This could besimply a feature of the current examination system, which fails to give a reward for anything otherthan success in the final examination, the latter of which depends heavily on book work.

The medical faculty at the University of Hong Kong is now changing to much more of a problem-based, problem-solving environment with continuous assessment. The current study providesclear baseline data for comparisons with this future course. It also provides techniques that aid thiscontinuous assessment and place it on far more of a quantitative and objective basis. The real-timevideo analysis has been adapted to incorporate aspects of MUTTER. Participants in small groupscan now be identified in real-time video, with their movement being automatically and theirutterance length, semi-automatically recorded. This has been linked to a note-taking and point-scoring ability such that individual contributions of value can be recorded on file. The equipmentrequired is unobtrusive and can be operated by the facilitator of the group. This offers thepossibility to produce an objective record of the progress of small groups in tackling problemswhich has been sadly lacking in systems of continuous assessment (where everyone tends to getthe same passing mark).

__________________

* The authors’ names have been arranged in alphabetical order.

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Action Learning in English and Anatomy - CEIcei.ust.hk/files/public/zfhku18371-385.pdf · Action Learning in English and Anatomy 373 reached this diagnosis. Patient cases always related